Primary tracheal tumors often present with locally advanced tumors. A majority of patients can safely undergo tracheal, laryngotracheal, or carinal resection with low perioperative risk. Airway interventions at the time of diagnosis should be selected carefully to avoid a compromise of curative treatment. Precise judgment is required to determine resectability. The proximity of intrathoracic organs creates anatomical limits to en bloc resection and necessitates adjuvant radiotherapy in malignant tumors. Early referral for consideration of surgical resection might offer the best opportunity for improving the overall prognosis of tracheal tumors.